Kawasaki disease

Diagnosis

There is no specific test that can confirm Kawasaki disease. In cases where a child exhibits only a subset of the symptoms, it may indicate an atypical or incomplete presentation of Kawasaki disease.

Other illnesses with similar signs and symptoms must be ruled out, such as scarlet fever, juvenile rheumatoid arthritis, Stevens-Johnson syndrome, toxic shock syndrome, mumps, and tick-borne diseases such as Rocky Mountain spotted fever.

Several tests may be required to confirm the diagnosis, such as:

• Physical examination: The diagnosis usually involves assessing the signs and symptoms and performing a physical examination.
• Blood tests: Anemia, high white blood cell count, and inflammation are indications of Kawasaki disease. Blood tests are often required to assess the blood cell count and rule out other disorders.
• Electrocardiogram: Heart rhythm issues might result from Kawasaki disease. An EKG is a noninvasive examination for assessing the heartbeat rhythm in the child’s heart. To measure the electrical impulses of the heartbeat, electrodes are affixed to the skin.
• Echocardiogram: This test involves utilizing an ultrasound device on the chest’s surface to detect issues with coronary arteries as well as observe how efficient the heart and artery’s function.

Treatment

The primary objective of the initial treatment for Kawasaki disease is to accomplish several key goals: reduce fever, decrease inflammation, mitigate the risk of arterial damage, prevent blood clots in individuals with coronary artery issues, and forestall any cardiac-related complications. To prevent lasting complications, it is crucial to initiate Kawasaki disease treatment as early as feasible, preferably while the child is still having a fever.

Common treatment options for Kawasaki disease include:

• Gamma globulin: Gamma globulin, an immune protein, can reduce the incidence of coronary artery issues when administered intravenously. It aids in reducing inflammation in the vessels. 10% of kids may not respond to the initial IVIG treatment and require a second dose or additional drugs.

Aspirin: Aspirin is often prescribed to reduce fever, pain, and joint inflammation. If taken at higher doses, may significantly reduce inflammation. Once the fever has subsided for 48 hours, it is likely that the aspirin dosage will be reduced.

Kawasaki disease treatment is an exception to the usual rule of not giving aspirin to children. This is because aspirin can lead to a rare and dangerous condition called Reye’s syndrome in children recovering from chickenpox or the flu. Aspirin should only be administered to kids with Kawasaki disease when a doctor is present to supervise the administration, which is usually done in a hospital setting at the initial treatment of the condition.

After the initial course of treatment: Kawasaki disease lasts approximately 12 days without therapy. Heart problems, however, could persist for a longer time.

After the initial gamma globulin treatment, the child may begin to improve with treatment.

The kid may need to take low-dose aspirin for at least six weeks after the fever has subsided and may be longer if coronary artery aneurysm developed. It may also be necessary to halt aspirin use in kids who contract the flu or chicken pox while receiving treatment.

Monitoring of cardiac issues: Depending on the type of cardiac issue present, Kawasaki disease-related heart complications are treated differently. Normally, the healthcare provider may advise follow-up tests to evaluate the child’s heart health periodically, typically at 6 to 8 weeks after the sickness started and then again at six months if there are any indications of heart issues.

Delay vaccination: Gamma globulin administration can influence the efficacy of specific vaccines. Healthcare providers should be informed if a child has a history of Kawasaki disease. Typically, it is recommended to wait at least 11 months before administering a live vaccine, such as those for chickenpox or measles, to children who have undergone gamma globulin treatment for Kawasaki disease.